My teenage daughter is concerned about her appearance and weight. She attends a yeshiva for girls. The hours are long. She is a serious, hardworking student, preparing for college entrance exams and loaded with homework. She is pretty but overweight. What would you suggest to help my daughter?
Mother of Yeshiva Student
Dear Mother of Yeshiva Student,
I am familiar with the yeshiva school system. My children and I graduated from yeshiva high schools. A person’s weight status is the product of the following: 1. Nature—age, gender and genetics. 2. Nurture—physical activity, diet and community influences.
3. Other Factors- medical conditions, hormonal abnormalities and medications.
Body Mass Index (BMI): is a measure of body weight relative to height. The BMI calculator produces a score that indicates whether a person is underweight, normal weight, overweight or obese. For children and teens ages 2 to 19 years, the BMI varies by age and sex. The BMI-for-age percentile is determined by comparing the teen’s weight to that of other teens of similar age and sex. By plotting your child’s BMI into the CDC’s BMI-for-age growth chart, you can determine your daughter’s weight status. You can also use the CDC’s online tool or ask your pediatrician.
Risks associated with being overweight or obese for children and teens:
- High blood pressure, high cholesterol, abnormal lipid profile and cardiac disease.
- Impaired glucose tolerance, insulin resistance and Type 2 diabetes.
- Respiratory problems and musculoskeletal discomfort.
- Fatty liver disease, gallstones and gastro-esophageal reflux (heartburn).
- Psychological problems such as anxiety and depression.
- Low self-esteem and lower self-reported quality of life.
- Social problems such as bullying and stigma.
*Unhealthy weight adversely affects both physical health and social-emotional quality of life. Obese children are more likely to become obese adults with risk factors that are even more severe.
Research suggests that about 35-40% of a child’s weight predisposition is inherited and in some cases as high as 55-60%. Addressing diet and physical activity can have a positive impact on health outcome.
Diet: Long yeshiva school days, homework, difficult courses and college application pressures are not excuses for unhealthy eating. Growing teenagers require adequate nutrients to promote growth, a healthy body and brain power.
Recommendations for teens: The Food Exchange System was created by the American Diabetic Association to aid in meal planning and guide in portion size control. The exchange list categorizes foods with similar nutritional content. Reading food labels is also informative.
Calories: Teenage boys require 2400-2800 calories daily depending upon growth and activity factors but no less than 1800 calories daily. Girls require 2200-2400 calories daily but not less than 1600 daily.
Protein: Consume lean meats, poultry, eggs, fish (fatty types too) and beans with legumes. Teens require 0.85-9.0g protein/kilogram body weight daily.
Milk: Calcium and Vitamin D are essential for bone and tooth health. Use lowfat dairy products such as; milk, yogurt and cheese to keep fat and calories controlled. Teens require 3 cups of milk and /or equivalent exchanges daily.
Grains: Whole wheat grains, pasta, rice and cereals are important as energy sources. Teens require 5-6 exchanges from the bread group.
Fruits and vegetables: Teens require 2-3 fresh fruits or fruit-group equivalents and 3-5 servings of vegetables daily for vitamin, mineral and fiber intake. Canned or frozen fruit should be unsweetened.
Fluids: 7 cups for teenage girls and 10.5 cups for teenage boys for proper hydration. Increased physical activity (e.g. sports) requires even more fluid intake.
Fat: Include monounsaturated and polyunsaturated sources such as olives oil, avocado, nuts (nut butters) and seeds. Fat is an “essential nutrient” but caloric.
Iron: Teenage boys require 11 mg of iron daily and girls require 15 mg daily to replace iron loss due to menstruation.
Food for Thought
Noshing: Students often snack on sugar-based soft drinks, milk shakes, candy and pretzels, etc. Fast foods, like pizza and deli items, are high in calories and fat. Encourage healthy snacks such as fruit, vegetables and/or a peanut butter sandwich.
Restaurants: Choose establishments that offer healthy selections. Avoid restaurants that mainly serve fried and high fat/sugar/salt/saucy items.
Shopping: The family food shopper impacts the family’s health. Purchase healthy foods. Avoid empty/high-calorie snacks and meal items.
Cooking: The cook can control the menu and recipes. Season with natural spices, lemon and lime. Avoid deep frying, caloric sauces and dressings.
Food Diary: A daily food diary allows for self-reflection and understanding of eating related behaviors. Note specific foods, portion sizes and time of day consuming items. Review the diary with your daughter. Discuss habits and needs non-judgmentally.
Doctors recommend children between 13-18 years exercise moderately–vigorously, one hour per day and at minimum 30 minutes, 3 x per week. Exercise maintains good health, fitness and a healthy weight during growth.
School: Mandatory school gym programs and extracurricular team sports offer regular opportunities to exercise.
Exercise class: Some gyms and community centers offer teen exercise classes.
Home gym: Home equipment—treadmills, stationary bikes, bands and free weights—make working out more accessible. Encourage your teen to use them.
Walking: A brisk mother-daughter walk might be a good way to bond and incorporate exercise in both of your lives! If walking to and from school is possible, it might be one way to get going.
Review your daughter’s hectic yeshiva schedule. Exercise is truly essential. Let her choose a favorite activity/sport and find time for her to have that physical activity in her life.
A Word About Sleep...
According to the American Academy of Sleep Medicine, teenagers require 8-10 hours of sleep daily. Most adolescents only get 6.5- 7.5 hours per night, and some even less. Teens experience a natural shift in their circadian rhythm. It is difficult for them to fall asleep before 11 p.m. Also, adolescents go through a second stage of cognitive maturation. Sleep supports brain development and physical growth spurts. Sleep deprivation leads to negative health related effects, including excessive snacking and weight issues.
Parents should model healthy lifestyle practices including diet, exercise and rest. Excess weight is unhealthy. Weight loss is a matter of diet and lifestyle adjustments. At Nutrition Transformations, we help you and your family members improve health, weight and wellbeing by working on diet and lifestyle. It’s a worthwhile investment.
Yours in good health,
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By Jennifer B. Chapler MS, RD, CDN